Relationship between CT findings of pulmonary tuberculosis and the number of acid-fast bacilli on sputum smears

Matsuoka, Shin; Uzawa, Katsuhiro; Shima, Hideki; Suzuki, Kiminori; Shimura, A; Sasaki, Yuka; Yamagishi, Fumio

doi:10.1016/s0899-7071(03)00148-7

Cited by 68 publications

(53 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2016; 4(2):e35919. on chest CT increases with the number of AFB on the sputum smear in adult patients with active pulmonary TB (14,15). In our study, all patients had sputum smear positivity more than 2+ AFB.…”

Section: Discussionsupporting

confidence: 47%

“…The evidence of previous primary pulmonary TB was present in 3 patients (cases 2, 3 and 6) in this study. Multiple cavities suggest an underlying immune compromised condition or the possibility of multidrug resistant tuberculosis (MDR-TB) (14,15). We found two patients with multiple cavities, one of them had MDR-TB who was afghan immigrant and the other one received pervious TB chemoprophylaxis.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Assessment of Cavitary Pulmonary Tuberculosis in Children

Lotfian

Mehrian

2016

Arch Pediatr Infect Dis

View full text Add to dashboard Cite

Background: Cavitary pulmonary tuberculosis (TB) is rare in children. Objectives: The aim of this study was to evaluate the characteristics of cavitary pulmonary TB in children. Patients and Methods: This retrospective study was conducted on 97 children less than 15 years old with pulmonary TB to assess the clinical characteristics and radiographic findings of patients with cavitary lesions. Results: Seven (7%) out of 97 children had cavitary pulmonary TB. All patients were between 13 and 14 years old with a female/male ratio of 2.5/1. The most common symptom was cough. All patients had positive sputum smear results. Cavitary lesions were seen in the right upper lobe in six cases and multiple cavities were observed in two cases. Conclusions: This finding strongly suggests that older children with pulmonary TB can be more at risk than younger ages. Special attention must be paid to the prevention and treatment of TB in older children, particularly females.

show abstract

Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 98%

Assessment of Cavitary Pulmonary Tuberculosis in Children

Lotfian

Mehrian

2016

Arch Pediatr Infect Dis

View full text Add to dashboard Cite

show abstract

“…Furthermore, CT can help in diagnosing PTB and in distinguishing active from inactive disease [8,9]. Nevertheless, Matsuoka et al [31 ]stated that the CT findings in smear-negative patients differ from those in smear-positive patients and suggested that CT findings are not helpful in judging smear-negative TB. Recently, Nakanishi et al [32 ]reported that the tree-in-bud appearance, lobular consolidation and large nodules are significantly associated with active PTB in smear-negative PTB, but the diagnostic accuracy was not satisfactory.…”

Section: Discussionmentioning

confidence: 99%

HRCT and Whole-Blood Interferon-γ Assay for the Rapid Diagnosis of Smear-Negative Pulmonary Tuberculosis

Lee

Shin²,

Kim³

et al. 2010

Respiration

View full text Add to dashboard Cite

Background: Early diagnosis of active pulmonary tuberculosis (PTB) is critical for TB control, and difficult in patients with smear-negative sputum. Objective: We wanted to evaluate the usefulness of clinical findings, high-resolution computed tomography (HRCT), interferon-γ-releasing assay (IGRA) and polymerase chain reaction (PCR) of sputum in the diagnosis of smear-negative PTB. Methods: From June 2006 to September 2008, 178 patients with suspected PTB on the basis of clinical and radiological findings visited our institute. After excluding smear-positive cases (n = 77) and cases with an inconclusive diagnosis (n = 17), we studied 84 patients. Their clinical records, HRCT, sputum TB-PCR assay and IGRA results were retrospectively evaluated. A QuantiFeron-TB Gold (QFT-G; Cellestis Ltd., Carnegie, Vic., Australia) assay was used for the IGRA. Results: Active PTB was diagnosed in 40 (48%) of 84 patients; lack of sputum and young age were significantly associated with an increased risk of PTB. The sensitivities of sputum PCR assay, IGRA, and HRCT were 43.2, 84.4 and 80.0%, respectively, and the specificities were 97.7, 82.9 and 70.5%, respectively. Among the 38 patients suspected of having PTB based on HRCT, 24 patients showed positive results on the IGRA, and 23 of these were diagnosed with active PTB. Among the 35 patients suggested not to have TB based on HRCT, 25 showed negative results on the IGRA, and 23 (92%) of these were diagnosed as not to have TB. Conclusion: The combined results of HRCT and the IGRA could help decision-making for early initiation of treatment in smear-negative patients.

show abstract

“…with cavitary disease have a higher sputum bacillary load than those with noncavitary disease (18,19). Cavitary disease at diagnosis and having a positive sputum culture after 2 months of treatment were associated with relapse in a recent phase 3 trial comparing rifampin and rifapentine-containing regimens (9).…”

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

Shortening Treatment in Adults with Noncavitary Tuberculosis and 2-Month Culture Conversion

Johnson¹,

Hadad²,

Dietze³

et al. 2009

Am J Respir Crit Care Med

131

108

View full text Add to dashboard Cite

Rationale: Cavitary disease and delayed culture conversion have been associated with relapse. Combining patient characteristics and measures of bacteriologic response might allow treatment shortening with current drugs in some patients. Objectives: To assess whether treatment could be shortened from 6 to 4 months in patients with noncavitary tuberculosis whose sputum cultures converted to negative after 2 months. Methods: This study was a randomized, open-label equivalence trial. HIV-uninfected adults with noncavitary tuberculosis were treated daily with isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months, followed by 2 months of isoniazid and rifampin. After 4 months, patients with drug-susceptible TB whose sputum cultures on solid media were negative after 8 weeks of treatment were randomly assigned to continue treatment for 2 more months or to stop treatment. Patients were followed for relapse for 30 months after beginning treatment. Measurements and Main Results: Enrollment was stopped by the safety monitoring committee after 394 patients were enrolled due to apparent increased risk for relapse in the 4-month arm. A total of 370 patients were eligible for per protocol analysis. Thirteen patients in the 4-month arm relapsed, compared with three subjects in the 6-month arm (7.0 vs. 1.6%; risk difference, 0.054; 95% confidence interval with Hauck-Anderson correction, 0.01-0.10). Conclusion: Shortening treatment from 6 to 4 months in adults with noncavitary disease and culture conversion after 2 months using current drugs resulted in a greater relapse rate. The combination of noncavitary disease and 2-month culture conversion was insufficient to identify patients with decreased risk for relapse.

show abstract

Relationship between CT findings of pulmonary tuberculosis and the number of acid-fast bacilli on sputum smears

Cited by 68 publications

References 13 publications

Assessment of Cavitary Pulmonary Tuberculosis in Children

Assessment of Cavitary Pulmonary Tuberculosis in Children

HRCT and Whole-Blood Interferon-γ Assay for the Rapid Diagnosis of Smear-Negative Pulmonary Tuberculosis

Shortening Treatment in Adults with Noncavitary Tuberculosis and 2-Month Culture Conversion

Contact Info

Product

Resources

About